Recently, several high-profile campaigns (including Bell Canada’s “Let’s Talk” initiative) have helped to raise public awareness about the important issue of mental health in Canada. These campaigns have coincided with hopeful political statements of support for expanding access to health care for Canadians living with mental illness.
For instance, at the Canada 2020 Health Summit in the fall of 2016, Federal Minister of Health Jane Philpott remarked on the importance of improving accessibility to pharmaceuticals for Canadians and emphasized the need to invest more in mental health treatment. However, a new study suggests that the political rhetoric about improving the mental health of Canadians is not matched by timely access in Canada’s public drug plans to the newest medicines available for the treatment of mental illness
The study, published by the Canadian Health Policy Institute (CHPI), examined how health technology assessment (HTA) decisions affect access to new drug treatments for mental health in Canada’s public drug plans. The data included all new drugs that were certified as safe and effective treatments by Health Canada, that were also submitted to the Canadian Agency for Drugs and Technologies in Health (CADTH) Common Drug Review (CDR) for HTA evaluation from 2004 to 2015. The experience of the group of mental health drugs was compared to the group of non-mental health drugs in terms of HTA outcomes and the eventual public drug plan coverage.
The study found that a higher percentage of non-mental health drugs (51.5%) compared to mental health drugs (23.8%) were recommended positively (with or without conditions) for public drug plan coverage by the CDR. The CDR also took less time to provide recommendations for non-mental health drugs (192 days) compared to mental health drugs (242 days). The CDR reviewed drug submissions covering 21 mental health indications during the study period. Schizophrenia (44%) and bipolar disorder (100%) are the only two mental health indications that received any positive recommendations from the CDR over this period. In contrast, none (0%) of the drugs for attention deficit hyperactivity disorder, dementia/Alzheimer’s disease, and major depressive disorder received any positive CDR recommendations. Public drug plans eventually covered many of the drugs rejected by the CDR, but only after lengthy waits. For mental health drugs, the average wait for drug plan coverage was 1173 days compared to 884 days for the non-mental health drugs.
The findings are important because clinical research reviewed for this study strongly suggested that a wide choice of therapy is important to be able to find the best treatment option for each patient because a one-size-fits-all approach does not work in treating mental illnesses. Delayed coverage of new medicines can restrict the range of treatment options for patients.
The study also suggested that delaying access to mental health treatments can cost more than the upfront investment in earlier access to a greater range of treatment options. It was estimated that in 2015, spending by the public drug plans of 9 provinces (excluding Quebec) and the federal government on the direct costs of new mental health drugs represented less than 1% of the nearly $55 billion in annual societal costs associated with the economic burden of mental illness in Canada.
Get the Study: HTA Decisions and Access to Mental Health Treatments in Canada’s Public Drug Plans, was authored by Brett J Skinner (Ph.D.), Nigel SB Rawson (Ph.D.) and Kimberley Tran (M.A.). It is available online at: www.canadianhealthpolicy.com.
About CHPI: Canadian Health Policy Institute (CHPI) is an independent think-tank dedicated to providing information and ideas for a better health system.
